Nature of Medical Ethics

Medical ethics, a branch of ethics, deals with moral decisions in various aspects of medicine. The Hippocratic oath is the most enduring tradition in medicine that has been the guiding ethical code for physicians since ancient Greece, and has eventually become the basis of all medical ethics. In its most compelling portions, it emphasizes the profundity of the medical agreement, the patient dignity, the confidentiality of the transaction, and the physician's responsibility to guard against abuse or corruption of his or her knowledge and art. It also exhorts the physicians to honor the rules of their profession and expose those who do not follow the high standards of conduct.

Ethical Decline of Profession

In the recent past, however, there has been a sharp decline in the ethical conduct of the medical practitioners all over the world. The 'dollar' is adored deity and the profession has been both privatized and commercialized. Materialistic influence has also led to the general belief that gratification of senses is the only way of enjoyment. This has produced highly selfish mentality and resultant exploitation of the patients without spiritual concept of life. The effect of this trend is seen in India also.

Causes of Ethical Decline

In India, many factors are responsible for the deterioration of morality in the medical practice.

• A large initial investment is required to set up a clinic, a hospital or a medical institute; and it is thought appropriate to charge heavy fees from the patients as a means of recovering the cost.
• Now a days there is increased awareness in the patient community about their legal rights. Thus doctors have a fear of getting charged, by consumer or other courts, for criminal negligence in treating the patients. Money required to plead the case may be substantial and hence the hospital charges are high.
• The patient approaches a doctor with mixed feeling of faith and fear, of hope and hostility. This inevitably leads to distorted doctor-patient relationship with high chances of exploitation.

Many doctors do not (or cannot) offer the best line of treatment to the patients:

Firstly because, some are ill trained. They themselves are not fully aware of recent advances in the treatment and management of the disease.

Secondly, many doctors do not have standard treatment facilities in their own clinics or hospitals. Instead of referring the patients to an institute where such facilities are available, the treating physicians do not inform about such facilities for fear of 'losing the patients'

Ethical Decline Unwarranted and Unfortunate

It is indeed difficult to understand why doctors today do not follow simple ethical practices. The doctors are educated and privileged class of people. They have enough prestige and are respected everywhere. Why can they not feel the suffering of patients? Even at the sad plight of the suffering humanity they don't desist from exploiting the poor. Some blame the prevalent system of medical education, while others try to put the responsibility on patients themselves. Most of the doctors, as well as literate class of people, seem not to bother about corruption in medical field any more. This is a grave situation. This 'modern' individualistic attitude and total lack of concern for the need of value-system in the life does not augur well for the future of medical scene in India. The declining moral trend indicates unhealthy inter human relationship. Appeal for political intervention, seeking help from Judiciary, or trying to rectify the situation through Medical Associations and Councils have proved to be of no avail.

Swami Vivekananda's Guidelines on Ethics

Despite honest attempts by the government, professional bodies, and non-governmental organizations, the decline in morality is not under check. In such a situation more radical and original approach is required. Such an approach that appeals to the spirit of humanity and which is universal in its extent is found in Vedanta as elaborated by Swami Vivekananda. For him all secular aspects, individual or social, were 'spiritual', and hence equally important.

Practice of Unselfishness

Swami Vivekananda successfully attempted to apply transcendental (spiritual) ethics to the empirical (worldly) plane of existence and created a new theory of ethics of universal relevance in the contemporary world.

The basis of ethics, according to Swami Vivekananda is to become more and more selfless: "Whether men understand it or not, they are impelled by that power behind to become unselfish. That is the foundation of morality. It is the quintessence of all ethics, preached in any language, or any religion, or by any prophet in the world. "Be thou unselfish", "Not 'I', but 'Thou'" - that is the background of ethical codes."

Recognition that I and Thou are One

This is more clearly brought out in Swami Vivekananda's other lectures: "Ethics cannot be derived from the mere sanctions of any personage, however great and divine he may have been. That you and I are not only brothers -every literature voicing man's struggle towards freedom has preached that for you -but that you and I are really one. This is the dictate of Indian philosophy. This oneness is the rationale of all ethics and spirituality. Every religion preaches that the essence of all morality is to do good to others. What is the reason that I should be moral? Know through Vedanta that whomsoever you hurt, you hurt yourself, they are all you… Herein is morality. Here, in Vedanta alone, is morality explained. The others teach you, but cannot give you its reason."

Giving up Privileges

With these convictions based on his knowledge of Vedanta, Swamiji was very much grieved to see people seeking privileges on the grounds of wealth, muscle-power, or intellect. He said:

"There is the still subtler and more powerful privilege of intellect; because one man knows more than others, he claims more privilege."

And he further added,

"Apply the same idea to the modern world: excess of knowledge and power, without holiness, makes human beings devils. Tremendous power is being acquired by the manufacture of machines and other appliances, and privilege is claimed today as it never has been claimed in the history of world. That is why the Vedanta wants to preach against it, to break down this tyrannizing over the souls of men."

No doubt, revival of medical ethics is fraught with many difficulties, but despite many constraints we should continue to work hard to break the stranglehold of these privileges. One can not do away with the difference between doctors and the patients; however, as Swami Vivekananda has said, 'But what can be attained is elimination of privilege. That really is the work before the whole world.'

Paying our obligation to the society

Swami Vivekananda has said that everyone (including the physician) has a social obligation to consider. At the expense of the patients and the society he is able to complete his education. It is his duty to repay that 'loan' as selfless service to the humanity.

'Serve with the knowledge that in serving other person we serve no other but God Himself', he maintained.